PHOENIX WELLNESS CENTER LLC NPI 1316135643

NPI Information

NPI: 1316135643
Provider Name: PHOENIX WELLNESS CENTER LLC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
142 MITCHELL ST SW
SUITE 200
ATLANTA, GA
ZIP 30303
Phone: (404) 584-2105
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PHOENIX WELLNESS CENTER LLC is a general practice in Atlanta, GA. PHOENIX WELLNESS CENTER LLC NPI is 1316135643. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

142 MITCHELL ST SW
SUITE 200
ATLANTA, GA
ZIP 30303-439
Phone: (404) 584-2105
Fax: (404) 584-2106

The provider's authorized official is Fabian Centeno .
The authorized official title is President and has the following contact phone number (404) 584-2105.

The enumeration date for this NPI number is 10/11/2007 and was last updated on 10/11/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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